Big numbers, scary numbers
Behind the numbers indicating the number of deaths per day, and the overall COVID-related deaths in the United Kingdom and around the world, are personal and family tragedies.
There's an awful lot of numbers around at the moment.
Let me tell you a few numbers that are on my mind. Britain has just passed the mark of 10,000 deaths from the coronavirus. And it seems almost inevitable that very soon we will pass the even more awful milestone of more than 1,000 COVID-19 deaths in a day.
These are grim statistics. Macabre. Scary. By some forecasts, Britain may end up as the European country worst hit by the pandemic - leapfrogging over France, Spain, and Italy in this least desirable of league tables.
But this isn't football. These are human lives - and the welfare of a society and a nation. Yet the numbers we are turning to for these forecasts - the figures on which we model the progress of the pandemic and make decisions about lockdowns and their lifting - are so much less precise than the football stats than fans wallow in.
Take the British figures. The daily tally of deaths is simply the number of people who have died in hospitals across Britain after testing positive for the virus. Those who died in care homes, sheltered accommodation, or residential centres for the elderly aren't counted. Nor are those who died while having COVID symptoms but who weren't tested.
Of course, those living in care homes - the elderly and the chronically unwell - are the most vulnerable to the virus. Some care homes have reported as many as fifteen of their residents succumbing to suspected COVID-19. So the 'official' figures for COVID deaths are a considerable underestimate - the real figure is probably between 10% and 30% above the widely touted government figure.
The problem is that the more comprehensive figure can only be based on death certificates - by counting how many of those record the virus as a cause of death. But the collation of that data takes up to two weeks. Normally that delay wouldn't matter; at the moment it does.
But even the daily hospital death figures are not fully up-to-the-moment. These are not the number of those who succumbed to the virus over the previous 24 hours - they are the number of deaths reported over that time. The death rate from the virus appears to decline at weekends - simply because the system of reporting hospital deaths isn't as comprehensive outside conventional office hours.
A thousand deaths a day sounds terrifying. But how many people die in the UK on an average day disregarding the pandemic? Well, about 1,600. Still, that means an extraordinary 60% increase in ordinary mortality rates. But hang on - given that quite a few of those dying in the pandemic are already seriously ill, then some may well have died in any case; they have died with COVID rather than of COVID if you see what I mean. So that needs to be taken into account.
On the other hand, we also need to put into any modelling the numbers dying indirectly because of the pandemic. Those who are not going to the hospital in time when very ill with non-COVID ailments because they are worried that medical services are overwhelmed - those whose treatment has been postponed because health services are focussing on tackling the pandemic - those whose urgent operations are being put off because their doctors say it's too risky for them to be admitted to hospital and so put at higher risk of contracting the virus. Just a handful of such deaths, you might imagine? I fear not.
So we will only know the real impact of the coronavirus when statisticians can identify the 'excess' of deaths over the routine or expected number - and that will take months. In the meantime, public health professionals and policymakers are making decisions based on partial numbers. Behind these numbers, large and small, are personal and family tragedies. But without reliable figures to inform policy and medical best practice, there could be many more of these tragedies than there need be.